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袖状胃切除术与单吻合口袖状回肠旁路术对心功能和心律失常的影响

Outcome of Sleeve Gastrectomy Versus Single Anastomosis Sleeve Ileal Bypass on the Cardiac Functions and Rhythm Disturbance.

作者信息

Abdelrahman Emad M, Ghali Mohamed Said, Mohamed Amr G, Elhady Fatma, Habib Shaimaa A, Ali Asmaa Ahmed, Elbagoury Zeyad Mohsen, Dawood Ahmed A, Negm Mahmoud A, Rizk Mahmoud, Abdelraouf Osama R, Elshora Ahmed A

机构信息

General Surgery Department, Faculty of Medicine, Benha University, Benha, Egypt.

General Surgery Department, Faculty of Medicine, Ain-Shams University, Cairo, Egypt.

出版信息

Obes Surg. 2025 Jun 26. doi: 10.1007/s11695-025-07928-z.

Abstract

BACKGROUND

Cardiovascular hemodynamics, electrophysiological characteristics, and heart anatomy are all negatively impacted by obesity. The aim of this study is to compare the impact of sleeve gastrectomy versus single anastomosis sleeve ileal bypass on cardiac functions and rhythm disturbance.

METHODS

The current study included 78 patients who were allocated into two equal groups. Group A (n = 39) underwent laparoscopic sleeve gastrectomy (LSG), while group B (n = 39) underwent single anastomosis sleeve ileal bypass (SASI). Follow-up was designed for 6 and 12 months for cardiac functions and rhythm disturbance.

RESULTS

The patients' mean age in the current study was 41.6 ± 6.88 and 43.2 ± 7.54 in groups A and B, respectively. There was a statistically significant longer operative time in patients who underwent SASI in comparison with those who underwent LSG (P < 0.001*). The %EWL was significantly higher in the SASI group at 6 and 12 months follow-up (P < 0.001*) QTC m sec and QT dispersion were significantly decreased within and between both groups after 6 and 12 months. There was a statistically significant improvement in the rhythm disturbance in both groups, mainly in group B, reported as a decrease in the overall AF with its subtypes in both groups. There was a statistically significant increase in the E/A ratio in both groups after 6 and 12 months follow-up, with no significant difference between both groups. There was an increase in LVEF in both groups, but it did not reach a significant value.

CONCLUSIONS

LSG and SASI seem to be effective techniques in improving cardiac functions and overall AF in obese patients.

摘要

背景

肥胖会对心血管血流动力学、电生理特征和心脏解剖结构产生负面影响。本研究的目的是比较袖状胃切除术与单吻合口袖状回肠旁路术对心脏功能和心律失常的影响。

方法

本研究纳入78例患者,平均分为两组。A组(n = 39)接受腹腔镜袖状胃切除术(LSG),B组(n = 39)接受单吻合口袖状回肠旁路术(SASI)。对心脏功能和心律失常进行6个月和12个月的随访。

结果

本研究中患者的平均年龄,A组为41.6±6.88岁,B组为43.2±7.54岁。与接受LSG的患者相比,接受SASI的患者手术时间在统计学上显著更长(P < 0.001*)。在6个月和12个月的随访中,SASI组的%EWL显著更高(P < 0.001*)。6个月和12个月后,两组内和两组间的QTC m秒和QT离散度均显著降低。两组的心律失常均有统计学意义的改善,主要是B组,表现为两组中总体房颤及其亚型的减少。6个月和12个月随访后,两组的E/A比值均有统计学意义的增加,两组间无显著差异。两组的左心室射血分数均有增加,但未达到显著水平。

结论

LSG和SASI似乎是改善肥胖患者心脏功能和总体房颤的有效技术。

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